Weekly Coronavirus Update: Tuesday, September 1, 2020

Happy Tuesday, friends! Below is a summary of the latest research findings and a bit of news relating to Covid-19. I hope you find this useful.

1) One thing we’ve heard from just about the beginning of this virus is that men are more susceptible to severe cases of Coronavirus. Previous research published in the journal Nature found that men were nearly twice as likely to develop severe cases and die from the virus than women. A new study also published in the peer-reviewed journal Nature sheds light on why this is the case. Researchers from Yale University studied a total of 98 males and females with moderate cases of Covid-19, finding that females “mounted significantly more robust T cell activation than male patients during SARS-CoV-2 infection, which was sustained in old age.” Basically, the male patients produced a weaker immune response to the virus than the female patients. The researchers concluded that vaccines and therapies to elevate the T-cell response in men are important. You can read the full study here: https://www.nature.com/articles/s41586-020-2700-3
And the first study referenced in this bullet point can be found here: https://www.nature.com/articles/s41586-020-2521-4

2) Six feet (or approximately two meters) of distance between people seems to be the standard number we’re told is “safe”. A new peer-reviewed study published in the medical journal BMJ, however, states that this is an outdated number “based on an outdated, dichotomous notion of respiratory droplet size.” Additional factors that should be considered when determining how much space to keep between people include things like air circulation, ventilation, the amount of time of exposure, whether people are wearing masks, crowd density, and whether people are silent, speaking, shouting or singing. The researchers developed a chart indicating the risk level of virus transmission in a variety of different scenarios, which is included below. The researchers state that in the higher risk scenarios, a distance greater than 6 feet apart is necessary. The authors concluded, “Physical distancing should be seen as only one part of a wider public health approach to containing the covid-19 pandemic. It needs to be implemented alongside combined strategies of people-air-surface-space management, including hand hygiene, cleaning, occupancy and indoor space and air managements, and appropriate protective equipment, such as masks, for the setting.” You can read the full study here: https://www.bmj.com/content/370/bmj.m3223

3) Returning to a topic I’ve written about in previous posts, what do we know about Covid-19 and asthma? A newly published study conducted by researchers at Harvard University examined the data of 492,768 participants in the UK BioBank. Narrowing the data to those patients who had asthma and Covid-19, and adjusting the data for age, sex, BMI, and other factors, the researchers found that those with non-allergic asthma were 48% more likely to develop severe Covid-19. For those with non-allergic asthma and chronic obstructive pulmonary disease, the risk was increased to 82%. Those with allergic asthma (asthma triggered by an allergy such as pollen or dust) were not significantly more likely to develop a severe case. You can read the full study here: https://www.jacionline.org/article/S0091-6749(20)30806-X/fulltext

4) Okay, let’s talk about the elephant in the room, also known as “comorbidities”, a hot topic as of just a few days ago. The knowledge that comorbidities, or existing health conditions such as obesity, high blood pressure, heart disease, or diabetes (to name a few), contribute to more severe cases of Covid-19, and often contribute to deaths of Covid-19 patients is NOT new. A quick search of Google Scholar (a search engine specifically for peer-reviewed research) using the terms “comorbidity” and “Covid-19” returns 3,300 unique results of published research articles in the year 2020 alone. The oldest of these was first published in early June 2020 in the peer-reviewed journal Clinical Immunology, and discussed comorbidities in Italian Covid-19 patients. The study found “more than half of the patients (56.3%) had comorbidities, with hypertension, coronary heart disease, diabetes and chronic kidney failure being the most common.” Additionally, those with comorbidities were at higher risk of dying. That study can be found here: https://www.sciencedirect.com/science/article/pii/S1521661620304563
--An additional peer-reviewed study published in the journal Postgraduate Medicine in late June analyzed the findings of 33 different published studies of patients around the world, finding that 40.8% of all Covid-19 cases in previous research had comorbidities, and nearly 75% of all Covid-19 deaths were in individuals with comorbidities. Diabetes and respiratory diseases were found to be the most prevalent comorbidities in cases resulting in death in that research. That study can be found here: https://www.tandfonline.com/doi/full/10.1080/00325481.2020.1786964
--Moral of the story — the CDC data (which has made quite a splash amongst some on social media) on Covid-19 patients who died with and without comorbidities really does not tell us anything we didn’t already know. If you were at greater risk due to an underlying health issue in the past, you still are. If you were not, you should still follow public health guidelines and be as safe as possible to protect yourself and others.

5) Did you ever think someone would study sociopaths and Coronavirus? A study published by Brazilian scholars in the peer-reviewed journal Personality and Individual Differences looked at the maladaptive personality traits, empathy, and compliance of 1,578 people. The people who scored highest on measures associated with antisocial personality disorder (also known as sociopathy) were less likely to follow public safety measures such as social distancing, wearing a mask, or washing their hands. This group had lower levels of empathy and higher levels of callousness, deceitfulness, and risk-taking. Those people who scored higher on the empathy measures were found to be significantly more compliant with public health guidelines. The researchers concluded, “These traits explain, at least partially, the reason why people continue not adhering to the containment measures even with increasing numbers of cases and deaths.” The full study can be read here: https://www.sciencedirect.com/science/article/pii/S0191886920305377

6) Researchers found that a two-day business conference held in Boston in February 2020 served as a super-spreader event of Covid-19. The researchers studied samples of the virus from nearly all confirmed cases in Massachusetts between January 29 — March 8, 2020, and continue to study additional samples after that. A total of 97 cases of Coronavirus were found amongst conference attendees and their contacts (note — at the time of the conference, there were only 15 confirmed cases of the virus in the US). By studying virus genomes, the researchers were able to link these cases to the conference, and then subsequently show that conference attendees spread the virus to US states such as Virginia, North Carolina, Indiana, Michigan, and Texas, as well as to countries such as Australia, Sweden, and Slovakia, among others. They also found that similar super-spreading of the same strain of the virus occurred in homeless shelters throughout Boston, with 122 residents infected by this specific virus sequence. The authors concluded, “This study provides direct evidence that superspreading events may profoundly alter the course of an epidemic and implies that prevention, detection, and mitigation of such events should be a priority for public health efforts.” The study has not yet undergone peer review (a very important disclaimer!), but was published in pre-print form on the website MedRxiv, which can be read here: https://www.medrxiv.org/content/10.1101/2020.08.23.20178236v1.full.pdf+html
Additionally, a Washington Post article about this study can be read here: https://www.washingtonpost.com/climate-environment/2020/08/25/boston-coronavirus-superspreading-event/?hpid=hp_hp-banner-main_virusboston-1030am%3Ahomepage%2Fstory-ans

7) A study published in pre-print form (not yet peer-reviewed) on medical journal The Lancet’s website documents the second known case of an individual being reinfected with Covid-19 after recovering from their first infection. The patient is a 25-year-old male in the US state of Nevada. Genetic tests showed that the individual was infected with two different strains of the virus. There were 48 days between his diagnoses. The patient’s first positive test was in April, and the onset of his symptoms began on March 25, including sore throat, cough, headache, nausea, and diarrhea. The patient then tested negative for the virus on May 9 and May 26. On May 31, however, he sought medical care for fever, headache, dizziness, cough, nausea, and diarrhea. Five days later he was hospitalized and required oxygen support. He was tested for the virus on June 5 and once again tested positive. The authors cautioned that “this may represent a rare event” and “The lack of comprehensive genomic sequencing of positive cases in the United States and worldwide limits the sophistication of public health surveillance required to find these cases.” You can read the full study here: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3681489

8) Finally, your US and world update. The US has surpassed the 6 million case mark, with a seven-day average of 41,492 new daily infections. Cases are currently spiking in states like Iowa, North Dakota, and South Dakota, and cases are also increasing in Alabama, Kansas, Nebraska, Minnesota, Montana, and Connecticut. Universities in the US are dealing with outbreaks, such as the University of Alabama where 1,200 students had tested positive as of Saturday, and the University of Dayton in Ohio, where 116 cases were reported on Thursday and then 148 more on Friday. Overall, at least 36 of the 50 US states have reported positive Covid-19 cases at universities.
--Elsewhere in the world, numbers are continuing to rise in the UK, with 1,715 new cases reported on Sunday, which was the highest daily number of cases since June 4. The current seven-day average number of daily new cases in the UK is 1,323, which is up from an average of 787 just four weeks ago. Experts warn that with schools reopening this week, there could be additional rises in case numbers.
--France is experiencing a spike in virus numbers, with 7,379 new cases recorded on Friday. It is the highest number of new daily cases in the country since the height of the pandemic in March.
--India, the third-most infected country in the world, reported the highest number of daily new cases of any country during the pandemic, with 78,761 new cases on Sunday. Cases are particularly on the rise in rural areas. Despite the increasing number of cases, the Indian government is allowing gatherings of up to 100 people and is reopening underground train networks in large cities.
Sources for all of this information:
US numbers: https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
US universities: https://edition.cnn.com/2020/08/30/health/us-coronavirus-sunday/index.html
UK numbers: https://www.theguardian.com/society/2020/aug/31/little-room-for-manoeuvre-as-uk-covid-cases-rise-say-experts
France numbers: https://www.theguardian.com/world/2020/aug/29/france-records-exponential-increase-in-covid-19-cases
India numbers: https://www.bbc.co.uk/news/world-asia-india-53969118

As always, please do your best to stay safe. There is still so much we don’t know about this virus!



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